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Feline-friendly handling guidelines aim for perfect veterinary visits

Veterinary team, pet owner have a hand in limiting stress in cat patients

Dr. Ilona Rodan, co-chair of the AAFP/ISFM Feline-Friendly Handling Guidelines panel, works with a

client and patient at her practice, the Cat Care Clinic in Madison, Wis., to decrease anxiety.Courtesy of Dr. Ilona Rodan

posted June 15, 2011

By R. Scott Nolen

The American Association of Feline Practitioners and International Society of Feline Medicine have come up with a set of recommendations for making cat visits to the veterinary clinic a less stressful affair—for patients, owners, and the entire veterinary team.

Although the number of pet cats exceeds the number of pet dogs in the United States, studies show cats are far more likely than their canine counterparts to go without veterinary care.

The Bayer Veterinary Care Usage Study identified difficulties associated with taking a pet cat to a veterinarian as a cause for the low frequency of visits. From loading the cat in the carrier to the frightened or aggressive behavior the animal expresses at the clinic—just thinking about the ordeal is enough to stress out many pet owners.

For Dr. Eliza K. Sundahl, owner of the KC Cat Clinic in Kansas City, the low number of feline veterinary visits is especially concerning, given that cats are masters at masking signs of disease. "Because cats are so good at hiding signs of illness and pain, owners may not recognize the need or value of a veterinary visit," she said. "And as owners often feel that the veterinary visit is such a stressful ordeal for their cat, they may be less likely to pursue wellness or other care that could identify problems before they get worse."

Dr. Sundahl is certified as a specialist in feline medicine by the American Board of Veterinary Practitioners and co-chairs the AAFP/ISFM panel that developed the Feline-Friendly Handling Guidelines. The panel developed the guidelines to provide veterinary team members and cat owners with strategies for minimizing the stress a trip to the clinic can cause feline patients, Dr. Sundahl said. Learning techniques for respectful cat handling within the veterinary hospital, she added, can show clients that their veterinarian is aware of the special needs of cats and facilitates the bond between the veterinarian and client.

Published in the May 2011 issue of the Journal of Feline Medicine and Surgery and endorsed by the American Animal Hospital Association, the guidelines explain how cats, as both predator and prey animals, will often show fear or defensiveness in unfamiliar environments or with unfamiliar people. Cats in such a state express an array of behaviors—including cowering, vocalizing, and aggression—that owners often find upsetting and that the veterinary team may be unprepared to address in a way that will minimize stress to the cat.

Photos in the guidelines illustrate a cat in the early stages of fear and anxiety. Clinic staff who recognize these facial and postural cues have an opportunity to intervene and prevent the patient's stress level from escalating into fear-aggressive behaviors such as biting and scratching.

"What we want to do is have the veterinary team learn to recognize behaviors all along the spectrum of fear, anxiety, and aggression, and learn strategies that can help defuse and de-escalate that stress," Dr. Sundahl said. "All of those techniques can be very simple and very effective in changing the experience for the cat and the owner."

Correspondingly, "Most of what we're talking about in the guidelines is very, very simple," she added.

Immediately ushering a feline patient into an examination room limits the pet's exposure to other cats and dogs, helping keep the animal's level of arousal low, the guidelines state. Synthetic feline facial pheromone analogs have been shown to calm cats, so placing diffusers around the office or examination room and spraying the pheromone on materials used for cats could be helpful. Draping a towel over the patient is another easy method to promote cat relaxation.

Given that a comfortable cat is less likely to struggle, the guidelines recommend tailoring examinations to each feline patient. For example, allow the cat to remain in a chosen position; if the pet would rather stay in its carrier, then conduct as much of the examination as possible with the animal in the carrier. "With cats, the adage of less is more is really applicable to them," Dr. Sundahl said.

Making human behaviors less threatening for cats

Avoid direct eye contact.

Move slowly and deliberately; minimize hand gestures.

Put yourself on the same level as the cat; approach from the side and do not loom above or over the cat.

Use a calm, quiet voice. Animated discussions may engage the client but scare the cat.

If the cat is anxious, return it to the carrier before going over instructions with the client, unless you need to demonstrate a technique.

Be aware of your own emotions and their potential effect on the cat's behavior.

– Excerpted from the AAFP/ISFM Feline-Friendly Handling Guidelines

There will always be that feline patient too fearful or aggressive to be handled safely, however, and chemical restraint may be necessary to carry out the examination or procedure. The guidelines list indications when chemical restraint is an option along with additional informational on drugs and protocols.

"Scruffing," a term describing a number of holds on the skin of the cat's neck, is not condoned by the panel that wrote the guidelines, which state scruffing should be used only as a last resort.

Clients also have a role in making the veterinary visit a positive experience. The guidelines offer strategies the veterinary team can suggest to cat owners before, during, and after their appointment. Using treats while rehearsing visits to the clinic and various aspects of the examination, such as looking in the cat's ears and mouth, can reduce anxiety during actual appointments. A handout for clients outlining these and other tips will be available from the AAFP this summer.

Dr. Sundahl recommends politely inquiring of every client—even the cat owners—whether they have one or more pet cats the veterinarian hasn't seen. "Often what we're finding is we're seeing one cat, but they've got two more at home we don't see," she said. "Ask about that and try to identify why they don't bring those cats in."

The veterinary team willing to go the extra mile to ensure the emotional well-being of their feline patients during their time at the clinic will not go unnoticed, according to Dr. Sundahl. "Owners see that, and they're likely to come back, and you'll have an opportunity to immensely improve the life of that animal," she said.

A PDF of the AAFP/ISFM Feline-Friendly Handling Guidelines can be downloaded for free at www.catvets.com.